sirolimus注意事项有什么？

Sirolimus is an immunosuppressant currently mainly used for immunomodulatory treatment in post-transplantation patients. Kidney transplant patients can obtain more obvious curative effects by using this drug. In order to ensure its efficacy, patients need to pay attention to the following aspects during the actual treatment process:

1. Sirolimus is taken orally, once a day, regularly with or without food.

2. The bioavailability of tablets after crushing, chewing or cutting has not been determined, so such use is not recommended. Patients who cannot take tablets should be prescribed the oral solution and instructed on its use.

3. Sirolimus should be started as early as possible after transplantation. It is recommended that sirolimus should be taken 4 hours after taking cyclosporine oral solution (modified) and/or cyclosporine capsules (modified) [cyclosporine microemulsion (modified)].

4. It has been proven that 2 mg sirolimus oral solution and 2 mg sirolimus tablets are clinically equivalent and therefore can be interchanged in equal amounts. However, the clinical equivalence of higher doses of sirolimus oral solution to higher dose tablets is unknown.

5. Combined use of sirolimus and cyclosporine in patients with low to moderate immune risk: For new kidney transplant recipients, it is recommended to use sirolimus in combination with cyclosporine and corticosteroids. A loading dose of sirolimus should be taken for the first time, which is 3 times the maintenance dose. The recommended loading dose for kidney transplant patients is 6 mg and the maintenance dose is 2 mg/day. To maintain sirolimus plasma concentrations within the target range, sirolimus plasma concentrations should be monitored. Although the loading dose of 15 mg and the maintenance dose of 5 mg/day used in clinical trials are safe and effective, the efficacy benefits of doses above 2 mg are unclear for kidney transplant patients. The overall safety profile of patients taking sirolimus oral solution 2 mg daily was better than that of patients taking sirolimus oral solution 5 mg daily.